Multi-slice CT scanners use EKG gating to predict the cardiac phase during slice reconstruction from projection data. Cardiac phase is generally defined with respect to the RR interval. The implicit assumption made is that the duration of events in a RR interval scales linearly when the heart rate changes. Using a more detailed EKG analysis, we evaluate the impact of relaxing this assumption on image quality. We developed a reconstruction algorithm that analyzes the associated EKG waveform to extract the natural cardiac states. A wavelet transform was used to decompose each RR-interval into P, QRS, and T waves. Subsequently, cardiac phase was defined with respect to these waves instead of a percentage or time delay from the beginning or the end of RR intervals. The projection data was then tagged with the cardiac phase and processed using temporal weights that are function of their cardiac phases. Finally, the tagged projection data were combined from multiple cardiac cycles using a multi-sector algorithm to reconstruct images. The new algorithm was applied to clinical data, collected on a 4-slice (GE LightSpeed Qx/i) and 8-slice CT scanner (GE LightSpeed Plus), with heart rates of 40 to 80 bpm. The quality of reconstruction is assessed by the visualization of the major arteries, e.g. RCA, LAD, LC in the reformat 3D images. Preliminary results indicate that Cardiac State Driven reconstruction algorithm offers better image quality than their RR-based counterparts.